정신질환자에 대한 외래치료명령제도
Outpatient treatment orders for mental health system
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초록
2009년에 정신보건법의 개정으로 외래치료명령제도가 도입되었다. 우리나라의 외래치료명령은 강제입원된 환자 중에서 구태여 입원하지 않아도 되는 환자로서 여전히 치료가 필요한 자에 대해서 행해지는 제도이다. 이 제도를 도입한 목적은 강제입원환자를 줄이는 것이 있다. 그런데 외래치료명령이 제대로 작동하기 위한 제도적 뒷받침이 거의 전무하기 때문에 현행 외래치료명령제도를 통하여 이러한 목적을 달성하는 것은 거의 불가능하다. 따라서 외래치료명령제도가 실효성을 거두기 위한 제도적 장치가 마련되지 않는 한 이 제도는 선언적인 의미만을 가지는 유명무실한 것이 될 것이다. 이를 위하여 현행법이 환자 본인 또는 그 보호자의 부담과 책임에 의하여 강제적인 치료를 받도록 하는 제도로부터 국가의 부담과 책임에 의해 제도의 실현이 이루어져야 한다. 이 제도를 운영하고 있는 다른 나라들의 경우에도 국가의 보건정책의 일환으로 외래치료명령제도를 운용하고 있다. 국가의 재정지원과 치료프로그램 및 지원프로그램의 마련이 없이는 이 제도가 성공할 수 없다. 따라서 우리나라에 있어서도 개인의 부담을 최소화하고 국가의 부담을 증대할 뿐만 아니라 국가에 의한 관리 및 감독체계가 이루어질 때 이 제도가 우리 사회에 정착되고 강제입원율도 감소할 수 있게 될 것이다.
Abstract
On March 21, 2008, a part of Korea's Mental Health Acts was amended to establish a new system of outpatient commitment. The purpose of the bill, which had come into force as of March 22, 2009, is to allow a mental patient to receive involuntary treatment as an outpatient instead of force them to the hospital. The new bill, outpatient commitment system, seeks to overcome the issues of involuntary hospitalization by allowing patient to stay in their community and ordain them to receive medical treatment. The amended law tries to minimize possible deprivation of liberty by applying the rule only to those who have been subjected under the involuntary hospitalization. The outpatient commitment system still places restrictions on a patient's liberty by forcing them to receive medical treatment. However, the degree of such dispossession is very limited compare to that of involuntary hospitalization and to that extent, it is an alternative to involuntary hospitalization. Nevertheless, the issue of human rights violation for the new system is a matter of dispute as it yet forces a patient to receive mandatory treatment regardless of the patient's will. Moreover, considering the fact that the purpose of such involuntary treatment while allowing the patient to stay outside of hospital is to prevent aggravation of the patient's state of illness or to avert possible harm that the patient might bring to the society, the new regulation must be understood as a precautionary order. However, forcing a patient to follow a certain course of action on the basis of a situation which has not been actualized in reality but to prevent such situation from happening in the future beforehand is indeed an invasion of a patient's liberty and therefore question of its constitutionality remains to be resolved. In the meantime, in order for the new system to be effective, development of various treatment programs are essential as well as proper regulation and management of the outpatients. In addition to that, government's subsidies for the patients must also be followed for the success of the amended law. Without such institutional foundations, the new system will just be nominal.
참고문헌 (14)
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